| NPI | 1548587371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: ME AC348) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 001909) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2011-02-18 |